Individual provider Active NPI

Somrit Koy Tim, ARNP

  • Acute Care Nurse Practitioner
  • Richland, WA
National Provider Identifier
1033932413
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP61651720 Issued in WA
Practice address
1100 Goethals Dr Ste E
Richland, WA 99352-3301
Phone
(509) 942-3095
Fax
(509) 942-3097
NPI assigned
Nov 5, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN60798186 WA
Acute Care Nurse Practitioner 363LA2100X AP61651720 WA Primary

Addresses

Primary practice location

1100 Goethals Dr Ste E
Richland, WA 99352-3301

Mailing address

550 Gage Blvd Ste 101
Richland, WA 99352-9532
Phone (509) 473-0637

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250218002957 WA Practitioner - Nurse Practitioner 3971023177 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kadlec Regional Medical CenterGroup PAC ID 9739098617, 402 clinicians

Practice addresses (Care Compare)

1100 Goethals Dr
Suite E
Richland, WA 99352-3301
Phone (509) 942-2986

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN60798186WAMDNurse Practitioner
AP61651720WAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kadlec Regional Medical Center CurrentSince Feb 10, 2025 Accepting new patients
Kadlec Regional Medical Center Current Accepting new patients
Kadlec Regional Medical Center CurrentSince Feb 10, 2025 Accepting new patients

Locations

1100 Goethals Dr
Ste E3
Richland, WA 99352

550 Gage Blvd
Ste 101
Richland, WA 99352

1100 Goethals Dr
Ste E
Richland, WA 99352
Phone (509) 942-3095

1100 Goethals Dr
#E3F
Richland, WA 99352

1135 Jadwin Ave
Richland, WA 99352
Phone (509) 942-3300

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1033932413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 GAGE BLVD STE 101",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993529532",
            "telephone_number": "509-473-0637",
            "fax_number": "509-627-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 GOETHALS DR STE E",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993523301",
            "telephone_number": "509-942-3095",
            "fax_number": "509-942-3097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIM",
        "first_name": "SOMRIT",
        "middle_name": "KOY",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-05",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "RN60798186",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WA",
            "license": "AP61651720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

Verify at the official NPI Registry.